Li D, Liu JH, Kang CB, Chen XF, Li XB, Lin DP, Li XW, Ye B, Zhang P, Liu QL. Re-evaluation of Alvarado score in diagnosis of acute appendicitis using transumbilical single-port laparoscopic exploration.
Shijie Huaren Xiaohua Zazhi 2013;
21:3024-3029. [DOI:
10.11569/wcjd.v21.i28.3024]
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Abstract
AIM: To re-evaluate the Alvarado score in the diagnosis of acute appendicitis using transumbilical single-port laparoscopic exploration.
METHODS: Clinical data for 210 patients with acute appendicitis who underwent transumbilical single-port laparoscopic exploration and Alvarado scoring were retrospectively reviewed. The correlation between Alvarado score and operative outcome was analyzed.
RESULTS: 101 had an Alvarado score above 9, of whom appendicitis was excluded by exploration in only 2 cases, and the diagnostic accuracy of Alvarado score was 98.1% in these patients. 85 patients had an Alvarado score between 7 and 8, of whom 74 were confirmed to have acute appendicitis by exploration, and the diagnostic accuracy of Alvarado score was 87.1% in these patients. Of 24 patients who had a positive CT or ultrasound finding and an Alvarado score between 5 and 6, 23 were confirmed to have acute appendicitis, and the diagnostic accuracy of Alvarado score was 95.8% in these patients. No port-site hernia or constipation was found during a follow-up period of 1 year.
CONCLUSION: Alvarado score is useful in the diagnosis of acute appendicitis, especially when the score is above 9. When the score is between 7 and 8, there is a false positive rate as high as 13% if the Alvarado system is used alone. Alvarado scoring combined with imaging examination is associated with a higher accuracy in the diagnosis of acute appendicitis.
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